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Could you be a coeliac?

It is estimated that 1 in 70 Australians suffer from Coeliac Disease – and a remarkable 80% remain misdiagnosed or undiagnosed. Could you be one of them? We take a look at the symptoms, risk factors and tests required to help you answer that question.

Coeliac Disease is Serious

Most people now know that Coeliac Disease is an intolerance to a protein in gluten, which can be found in wheat, rye, barley and oats.  But many are unaware of what a serious condition it is.  

When a coeliac consumes gluten it triggers an abnormal immune reaction, causing inflammation and damage to the small bowel lining.  The tiny, fingerlike protrusions in the small intestine, called villi, which are responsible for the absorption of nutrition become lost.  This damage leads to malnutrition regardless of how well you eat. A scary thought!

Why Does Coeliac Disease Go Undiagnosed?

Unfortunately Coeliac Disease can produce a wide range of symptoms, many of which are consistent with other diseases and disorders, so it’s not always easy to know when you and your doctor should suspect Coeliac Disease.

The most common signs are diarrhea, fatigue and weight loss.  Other frequent symptoms include bloating, abdominal pain, nausea, constipation and vomiting.

These digestive symptoms are what you might expect.  Yet for more than 50% of coeliac sufferers their symptoms have nothing apparently to do with the gut. Instead indications may include iron deficiency or anemia, osteoporosis, damaged dental enamel, mouth ulcers, headaches, hair loss, tingling hands and feet, problems with balance, joint pain, depression or skin rash. 

In fact, The University of Chicago Celiac Disease Centre has identified more than 300 symptoms of Coeliac Disease: everything from psychological to physical to neurological.  It’s not hard to see why Coeliac Disease can so often go undiagnosed.

It is even possible for a coeliac sufferer to be completely asymptomatic.  Sadly there is no correlation between symptoms and bowel damage. So just because you feel okay doesn’t mean you aren’t damaging your intestine.

The other confusing factor is that Coeliac Disease can be triggered at almost any age.  You may have been happily consuming gluten for years before the disease kicks in. 

Although Coeliac Disease is genetic, having the gene doesn’t mean you have the disease.  An environmental trigger is usually required before the disease actually occurs. Researchers have identified viral infection, post surgery, pregnancy, childbirth or severe emotional stress as possible triggers.

Am I at Risk?

If you have any of the symptoms and/or triggers of Coeliac Disease then you should talk to your doctor. This is particularly true if you are in a high-risk group.

If there is a family history of Coeliac Disease then you have a 10-20% risk of getting the disease yourself. Even if you don’t have symptoms you may want to talk to your doctor about being tested.

People with Coeliac Disease are at greater risk of developing other autoimmune diseases and vice versa. So if you suffer from type 1 diabetes, autoimmune thyroid disease, Addison’s Disease or other autoimmune conditions then you are at higher risk of Coeliac Disease as well.

How Do I Find Out for Sure?

If Coeliac Disease is suspected it is very important that you do NOT stop eating gluten until AFTER you have been properly tested.  If there is no gluten in your system at the time of the tests, you may get a false negative result.

Testing usually starts with a simple blood test.  This measures antibody levels, which are typically elevated in people with untreated Coeliac Disease. Usually a negative blood test result will rule out Coeliac Disease. However, it is possible to get a negative result and still have the disease, and this test tends to be less reliable in children under four.

Gene testing is also available. Only 1 in 30 people with the gene will actually have Coeliac Disease, so a positive result will only tell you that you are genetically predisposed.  However a negative result will effectively rule out the condition. (One advantage of gene testing is that it can be used when people have already commenced a gluten free diet.)

The only definitive test for Coeliac Disease is an endoscopy or biopsy.  In this 10-minute procedure a gastroenterologist obtains a tiny sample of intestinal tissue.  The tissue is examined under a microscope to determine if there is evidence of villous atrophy, the damage caused by Coeliac Disease. 

What if I Do Have Coeliac Disease

Treatment for Coeliac Disease is the complete removal of all gluten containing foods from the diet.

The good news is that removing gluten not only controls the symptoms, it heals any intestinal damage and prevents further damage.  The small intestine can be completely healed within 3-6 months on a strict diet.

The bad news is that you must commit to a gluten free diet for life and it does take some getting used to. Luckily labeling laws are making it easier to identify safe foods and it is increasingly easy to find gluten free foods in the supermarket and order gluten free meals in restaurants or airlines.

The Bottom Line

Left untreated, Coeliac Disease can adversely affect almost every system in your body. But early diagnosis and treatment can reduce your risk of most problems ever occurring.  If you are at risk or have any of the possible symptoms of Coeliac Disease, it’s worth talking to your doctor. 

If you feel unsure then consider chatting with your community pharmacist.  He or she can offer advice and will refer you to a doctor if appropriate or necessary.

If you do have Coeliac Disease then your pharmacist can provide advice on lifestyle management to help you enjoy a better quality of life.

 

Your Health Experts

This was produced as part of the Your Health Experts program.  We are working with other local health experts to bring you the tips, advice and information you need to lead a healthy life. To make sure you get all this great information subscribe to our monthly mini-mag and Like us on Facebook.

 

[1] Source: Coeliac Australia

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